2018, Number 4
Short and long-term outcomes of the re-hepatectomies as part of multi-modal treatment of hepatic metastases from colo-rectal origin. Bi-institutional study
PDF size: 229.56 Kb.
ABSTRACTIntroduction: A high percentage of patients undergoing hepatectomy for metastatic colorectal liver disease will have a recurrence. Of these, some can be subject to a new resection. The usefulness of repeated hepatectomy remains controversial. The aim of this study is to evaluate the results of short and long-term outcomes in repeated hepatectomies. Methods: They were re-analyzed 68 repeated hepatectomies from two institutions. Demographics, characteristics of metastatic disease and hepatic resections were analyzed. Types of complications, morbidity and mortality were also analyzed as survival and disease-free time. Some of the factors of poor prognosis mentioned in the literature were evaluated. Results: The analysis of short-term data showed no statistically significant differences between patients with first and repeated hepatectomy, except the percentage of postoperative biliary leakage (p = 0.001). The 1-year survival was similar while 3 and 5 years survival showed significant differences (p = 0.024 and 0.004, respectively). The factors of poor prognosis referred in the literature were not representative in this series. Conclusion: The short-term results of repeated hepatectomy are similar to those resected once. Long term result are inferior to other published series.
De Jong M, Mayo S, Pulitano C, Lanella S, Ribero D, Strub J, et al. Repeat curative intent liver surgery is safe and effective for recurrent colorectal liver metastasis: results from an inter-institutional analysis. Gastrointest Surg. 2009;13:2141-51.
Bismuth H. Surgical anatomy and anatomical surgery of the liver. World J Surg. 1982;6:3-9.
Gonzalez H, Figueras J. Practical questions in liver metastases of colorectal cancer: general principles of treatment. HPB. 2007;9:251-8.
Makuuchi M, Takayasu K, Takuma Y. Preoperative trans-catheter embolization of the portal venous branch for patients receiving extended lobectomy due to bile duct carcinoma. J Jpn Surg Assoc. 1984;45:1558-64.
Stolz A, Gagniere J, Dupre M, Rivoire M. Destruction locoregionale des metastases hepatiques d´origine colorectale. Place de la radiofrequence. Journal de Chirurgie Viscerale. 2014;151:534-46.
De Santibáñez E, Clavien J. Playing play-doh to prevent postoperative liver failure. The “ALPPS” approach. Ann Surg. 2012;255:415-7.
Wichters D, De Haas R, Salloum C, Andreani P, Pascal G, Sotirov D, et al. Repeat hepatectomy for recurrent colorectal metastases. Br J Surg. 2013;100:808-18.
Adair R, Young A, Cockbain A, Malde D, Prasad K, Lodge J, et al. Repeat hepatic resection for colorectal liver metastases. Br J Surg. 2012;99:1278‑83.
Tranchart H, Chirica M, Faron M, Balladur P, Lefevre L, Svrcek M, et al. Prognostic impact of positive surgical margins after resection of colorectal cancer liver metastases: reappraisal in the era of modern chemotherapy. World J Surg. 2013;37:2647-54.
Tuttle T, Curley S, Roh M. Repeat hepatic resection as effective treatment for recurrent colorectal liver metastases. Ann Surg Oncol. 1997;4:125-30.
Grundmann R. Current state of surgical treatment of liver metastases from colorectal cancer. Word J Gastrointest Surg. 2011;27:183-96.
Ahmad A, Chen S, Bilchik A. Role of repeated hepatectomy in the multimodal treatment of hepatic colorectal metastases. Arch Surg. 2007;142 526-32.
Ishiguru S, Akasu T, Fujimoto Y, Yamamoto J, Sakamoto Y, Sano T, et al. Second hepatectomy for recurrent colorectal liver metastasis: analysis of preoperative prognostic factors. Ann Surg Oncol. 2006;13:1579-87.
Tanaka K, Shimada H, Ohta M, Togo S, Saitou S, Yamaguchi S, et al. Procedures of choice for resection of primary and recurrent liver metastases from colorectal cancer. World J Surg. 2004;28:482-7.
Jones N, McNally M, Malhorta L, Abdel-Misih S, Martin E, Bloomston M, et al. Repeat hepatectomy for metastatic colorectal cancer is safe but marginally effective. Ann Surg Oncol. 2012;19:2224-9.
Cai G, Cai S. Multi-modality treatment of colorectal liver metastases. World J Gastroenterol. 2012;18:16-24.
Adam R, de Gramont A, Figueras J, Guthre A, Korudo N, Kunstlinger F, et al. The oncosurgery approach to managing liver metastases from colorectal cancer: a multidisciplinary international consensus. Oncologist. 2012;17:1225-39.
Van der Pool A, Lalmahomed Z, De Wilt J, Eggermont A, Ijzermans J, Verhoef C. Local treatment for recurrent colorectal hepatic metastases after partial heatectomy. J Gastrointest Surg. 2009;13:890-5.
De Jong M, Pulitano C, Ribero D, Strub J, Mentha G, Schulick R, et al. Rates and patterns of recurrence following curative intent surgery for colorectal liver metastasis: an international multi-institutional analysis of 1669 patients. Ann Surg. 2009;250:440-8.
Fong Y, Blumgart LH, Cohen A, Fortner J, Brennan M. Repeat hepatic resection for metastatic colorectal cancer. Ann Surg. 1994;220:657-62.
Nordlinger B, Vaillant J, Guiguet M, Balladur P, Paris F, Bachellier P, et al. Survival benefit of repeat liver resections for recurrent colorectal metastases: 143 cases. Association Francaise de Chirurgie. J Clin Oncol. 1994;12:1491-6.
Suzuki S, Sakaguchi T, Yokoi Y, Kurachi K, Okamoto K, Okumura T, et al. Impact of repeat hepatectomy on recurrent colorectal liver metastases. Surgery. 2001;129:421-8.
Sugawara G, Isogai M, Kaneoka Y, Suzuki M, Yamaguchi A. Repeat hepatectomy for recurrent colorectal metastases. Surg Today. 2005;35:282-9.
Treska V, Salaicky T, Liska V, Ferda J. Repeated procedures for colorectal liver metastases. Hepatogastroenterology. 2007;54:1775-8.
Nishio H, Hamady Z, Malik H, Fenwick S, Rajendra Pasad K, Toogood G, et al. Outcome following repeat liver resection for colorectal liver metastases. Eur J Surg Oncol. 2007;33:729-34.
Adam R, Bismuth H, Castaing D, Waechter F, Navarro F, Abascal A, et al. Repeat hepatectomy for colorectal metastases. Ann Surg. 1997;225:51-62.
Strasberg S, Phillips C. Use and dissemination of the Brisbane 2000 nomenclature of liver anatomy and resections. Ann Surg. 2013;257:377‑82.
Dindo D, Demartines N, Clavien P. Classification of surgical complications. A new proposal with evaluation in a cohort of 6336 patients and results of survey. Ann Surg. 2004;240:205-13.
Balzan S, Belghiti J, Farges O, Ogata S, Sauvanet A, Delefosse D, et al. The 50-50 criteria on postoperative day 5: an accurate predictor of liver failure and death after hepatectomy. Ann Surg. 2005;242:824-8.
Sa Cunha A, Laurent C, Rault A, Coudere P, Rullier E, Saric J. A second liver resection due to recurrent colorectal liver metastases. Arch Surg. 2007;142:1144-9.
Pessaux P, Lermite E, Brechant O, Tuech J, Lorimier G, Arnaud J. Repeat hepatectomy for recurrent colorectal liver metastases. J Surg Oncol. 2006;93:1-7.
Muratore A, Polastri R, Bouzari H, Vergara V, Ferrero A, Capussotti L. Repeat hepatectomy for colorectal liver metastases: a worthwhile operation? J Surg Oncol. 2001;76:127-32.
Nagakura S, Shirai Y, Suda T, Hatakeyama K. Multiple repeat resections of intra and extra-hepatic recurrences in patients undergoing initial hepatectomy for colorectal carcinoma metastases. World J Surg. 2002;26:141-7.
Kin T, Nakajima Y, Kanehiro H, Hisanaga M, Ohyama T, Nishio K, et al. Repeat hepatectomy for recurrent colorectal metastases. World J Surg. 1998;22:1087-91.
Khan S, Matthews J. Intraoperative margin re-resection for colorectal cancer liver metastases. Hepatobiliary Surg Nutr. 2013;2:108-2.
Nari G, Palacios O, López Ben S, Albiol M, Falgueras L, Castro Gutiérrez E, et al. Hilar cholangiocarcinoma: the number of positive nodes and positive node/total node ratio is a significant prognostic factor for survival. Cir Esp. 2014;92:247-53.
Petrowsky H, Gönen M, Jarnagin W, Lorenz M, DeMatteo R, Heinrich S, et al. Second liver resections are safe and effective treatment for recurrent hepatic metastases from colorectal cancer: a bi-institutional analysis. Ann Surg. 2002;235:863-71.
Figueras J, Torras J, LLadó L, Ramos E, Martí-Rogue J, Serrano T, et al. Surgical resection of colorectal liver metastases in patients with expanded indications: a single center experience with 501 patients. Dis Col Rectum. 2007;50:478-88.